Effects of intermittent diethylstilbestrol diphosphate administration on the R3327 rat prostatic carcinoma

Clinical trials have utilized intermittent diethylstilbestrol diphosphate (DES) therapy in advanced symptomatic prostatic carcinoma to diminish the morbidity of standard endocrine therapy. To determine the effect of intermittent DES administration on the Dunning R3327 rat prostatic adenocarcinoma 60 days following tumor implant, 6 groups were randomly assigned: control (N = 8), castrate (N = 10), high dose DES (N = 8, 1.6 micrograms/ml DES continuously in drinking water), low dose DES (N = 10, 0.4 microgram/ml continuously in drinking water), intermittent high dose DES (N = 10, 1.6 micrograms/ml DES in drinking water for 1 week, then off for 3 weeks), and intermittent low dose DES (N = 10, 0.4 microgram/ml DES for 1 week, then off for 3 weeks). Results indicate that low or high dose DES, and intermittent low or intermittent high dose DES during the week of administration were able to reduce serum testosterone to castrate levels (0.1 ng/ml). After withdrawal of intermittent DES, serum testosterone returned toward control levels (1.0 ng/ml). Initial mean tumor burden between control and treatment groups was not significantly different. All DES exposed rats had a tumor volume at death (range, 15.6-18.3 cm3) smaller than control (mean, 25.4 cm3) or castrate (mean, 40.8 cm3) rats. Despite this significant survival advantage from the time of randomization was achieved only in castrate (median survival, 331 days) or high dose DES (median survival, 359 days) groups compared to control (median survival, 225 days). Similarly, significant prolongation in tumor doubling time was achieved only by rats receiving castration or high dose DES. Intermittent DES administration controls tumor volume but does not provide a survival advantage. In this respect, intermittent DES is inferior to castration.     

新改良式远端脾肾静脉分流术

本文报告一种新的改良式远端脾肾静脉分流术,即脾静脉与左肾静脉侧侧吻合、脾静脉远端结扎,再将胃冠状静脉结扎。作者经治7例,初步观察疗效较好,术后无死亡,无复发出血,无肝性脑病发生。本文对这种手术的步骤和优点进行了讨论和分析。     

切开复位内固定治疗Gartland Ⅲ型肱骨髁上骨折

目的探讨切开复位内固定治疗Gartland Ⅲ型肱骨髁上骨折的疗效。方法1999年10月-2005年4月，对62例平均年龄7．5岁的患儿，应用切开复位克氏针固定治疗Gartland Ⅲ型肱骨髁上骨折。其中伸直尺偏型41例，伸直桡偏型18例，伸直中间型3例；无伴发血管、神经损伤和筋膜室间隔综合征。闭合性骨折47例，开放性骨折15例。结果术后56例获得随访，随访时间为6～15个月，平均11．5个月。所有骨折均获得愈合。根据Flynn标准进行疗效评价，其中优22例（占39．3％），良21例（37．5％），可9例（16．1％），差4例（7．1％）。伤后8h内手术的优良率为89．7％，伤后8h后手术的优良率为63．0％。直接手术治疗的优良率为90．1％，曾接受手法复位的优良率为67．7％。结论切开复位内固定治疗Gartland Ⅲ型肱骨髁上骨折可取得满意的疗效，是安全、有效的治疗方法。     

我院护士工作评估体系及其应用

目的应用护士工作评估体系,激励护士不断自我完善.方法以自我评估、面对面交流、同事间评估、设立目标和建立护士档案为主要内容的评估.一般为每年1次.结果每年护士评估的覆盖率为100%.提供了上下级面对面交流的机会,每名护士都熟悉评估的程序并自觉参与.结论护士评估体系是护理管理的重要组成部分,它使管理者有机会关注到每名护士的成长需要及成长目标,指导我们能动地利用人力--这一最宝贵的资源.     

Patterns of cancer distribution in a medical center among adolescents 14 to 17 years of age for the period 1995 to 2001.

BACKGROUND AND PURPOSE: There are limited data on the pattern of cancer distribution among adolescents in Taiwan. This study evaluated the characteristics of these rare cancers in a medical center. METHODS: Analyses of the characteristics of malignant neoplasms for patients aged 14 to 17 years at diagnosis were performed for all cases recorded in the tumor registry of Chang Gung Memorial Hospital (CGMH) at Linkou for the period 1995 to 2001. All eligible tumors were categorized in 1 of 12 diagnostic groups according to the scheme of the International Classification of Childhood Cancer (ICCC). Relative frequencies, age, and gender variations and the characteristics of tumor types were analyzed. RESULTS: Cancer was diagnosed in 320 adolescents during the study period. The male/female ratio was 1.17. Leukemia was the leading diagnostic group. The frequency of carcinomas increased with age and was highest among 17-year-olds. In this age group, non-rhabdomyosarcoma soft tissue sarcoma/primitive neuroectodermal tumor (non-RMS STS/PNET), thyroid carcinoma (CA) and ovarian germ cell tumor (GCT) were the 3 most common solid tumors; the embryonal malignancies were rare. Tumors with the greatest male predominance were intracranial GCT (91%), nasopharyngeal CA (87.5%), osteosarcoma (84.6%), and colorectal CA (75%). Tumors with the greatest female predominance were thyroid CA (78.3%), gonadal GCT (75%), and non-RMS/PNET (56.5%). Hepatocellular CA comprised 9.4% of all carcinomas. CONCLUSIONS: The relative frequency and the distribution of histology subtypes among adolescents were between those of childhood and adult cancers. There were marked variations in tumor occurrence between genders and among different ages.     

Functional correlates of Doppler flow study of the female urethral vasculature.

OBJECTIVES: To examine the effect of individual patient factors (age, parity, body mass index, menstrual cycle, menopause, hormone replacement therapy, bladder neck position and urethral mobility) on the appearance of Doppler flow in urethral vessels, to investigate the association between the Doppler flow parameters and intrinsic urethral function, storage and voiding, and to explore differences in the urethral vasculature between subjects with and without urodynamic stress incontinence (USI). METHODS: Over a 4-year period we prospectively performed imaging studies in 355 women, including 244 who denied any lower urinary tract symptoms within the previous 3 months (Group A) and 111 who had had lower urinary tract symptoms (Group B). Studies included morphologic assessment and Doppler flow investigation of the lower urinary tract. Vascular flow velocity and vessel density in the urethral vasculature were measured. For women in Group B, multichannel urodynamic studies were also performed. RESULTS: The urethral vasculature has five main branches of vessels. Their appearance was not affected by the menstrual cycle or menopause except for those of the anterior vaginal vessel and anterior branch of the middle urethral vessel. Other than that of the posterior urethral vessel, in which there was a correlation with parity, the resistance index (RI) was not affected by individual patient factors. However, there was a correlation between the vascular index (VI) and individual factors such as age (r = -0.336, P = 0.002), body mass index (r = -0.287, P = 0.028), menopause (r = -0.402, P < 0.001), and hormone replacement therapy (r = 0.392, P = 0.027). Only the VI and RI of the posterior urethral vessel correlated significantly with the urethral pressure profile. In subjects with lower urinary tract symptoms, the appearance of the urethral vasculature on power Doppler imaging and the corresponding RI and VI values were not correlated with objective evidence of USI. CONCLUSION: Patient factors may affect specific Doppler flow parameters of the urethral vasculature, which are related to intrinsic resting urethral closure. There is no difference in the appearance of the urethral vasculature in subjects with or without USI.     

自体腹白线片修补十二指肠溃疡穿孔(附13例报告)

目的探讨用游离自体腹白线片修补急性十二指肠溃疡穿孔的应用价值。方法从2006年1月至2006年7月对13例用自体腹白线片修补急性十二指肠溃疡穿孔的病人的临床资料和随访情况进行回顾性分析,其中2例穿孔大于2cm2,平均手术时间60分钟,平均失血量20ml,平均住院天数9±1天。结果游离自体腹白线片修补急性十二指肠溃疡穿孔13例均痊愈出院。随访15天至6个月,无手术并发症。结论本方法操作较简单、安全、效果好,其适应症广,是一种可行的新方法。